Amyloid Corneal Degeneration is the degeneration due to amyloid deposits in the various layers of the cornea. Amyloids basically refer to the group of proteins characterized by a fibrillary morphology, extracellular, proteinaceous deposits found in organs and tissues. Amyloid structurally consist of repeated units of β-sheet structure. It can be correlated with Avarna Shukra in Ayurveda as it basically contains corneal opacities discussed later on in this article.
Polymorphic amyloid degeneration is a bilateral disorder which affects the middle and old age group and is characterized by deposition of amyloids which is non-progressive in nature within the corneal stroma mostly in mid to deep corneal stromal layers. The deposits form multiple and filament-like opacities in an axial distribution. The name Amyloid Corneal Degeneration was given by Mannis et al in 1975. The older name, polymorphous stromal dystrophy, was given by Thomsitt and Bron. Due to lack of evidence of heritability the term degeneration instead of a dystrophy was introduced and it is present only in people older than 50 years of age.
- Mostly no genetic basis of inheritance.
- This disease usually manifests after 50 years of age.
- There is no sexual predominance, i.e. affects both male & females equally.
- Non progressive disorder i.e. the amyloid deposits don’t progress.
- Relatively an asymptomatic condition.
SIGNS AND SYMPTOMS
- Gray or white opacities which are of distinct shapes mostly filament-like in shapes present in the mid to deep corneal stroma, most commonly in a mid-peripheral annular distribution.
- No inflammation is seen.
- Whitish, gelatin-like amyloid deposits are observed in the sub epithelial region giving the corneal surface a multi lobulated appearance which looks similar to mulberry.
- Corneal changes range from anterior stromal to even sub epithelial vascularization.
- Normal distant and near vision
- Sometimes there is slight reduction in visual acuity as much as one line.
- Loss of vision can be severe when the deposits fuse to cause opacity in the cornea
- Clinical: Slit Lamp examination.
- Histopathology: Eosinophilic deposits in the stroma are stained with Congo red and these are subjected under polarized light and they show a dichromatic nature. They are
- PAS -negative,
- With Masson’s trichrome- stain red
- Confocal microscopy can show lesions within the various layers of cornea including Descemet’s membrane, anterior corneal stroma and deep corneal stroma.
This condition can be confused with these following conditions due to resemblances in the clinical picture:
- Lattice dystrophy of Cornea Type 1
- Fleck dystrophy.
- Schnyder crystalline corneal dystrophy.
- Granular corneal dystrophy Type 2 (Granular-lattice dystrophy)
Correlation in Ayurveda
As Amyloid corneal degeneration are basically corneal opacities so due to the resemblance in features we can co relate it with avran shukra.
The quoted Shloka was written by Acharya Susrutha (Ref.-Sushruth Uttaratantra 5/8) and it explains the clinical picture of the Avarna shukra:
Meaning of Shloka: If the corneal part of the eye gets a cloud-like white appearance due conjunctivitis, and doesn’t have much pain or tears. This condition is known as Avarna Shukra.
Prognosis: Good, if the disease’s condition is non-progressive or any kind of difficulty in vision. As Avarna Shukra is located in the deeper layers of the cornea i.e. 2nd and 3rd layers, when it becomes thicker, chronic then it is difficult to treat.
Some conditions/clinical observations given by Acharaya Bhagbhatta for the condition after which the condition of disease becomes asadhya (non-treatable) when: (Ref. Ashtanga Hridaya uttarsthana 10/31)
- There is loss of vision due to the opacity.(shukra)
- The opacity starts giving red or black colored appearances.
- It is very inflamed or too deep.
- It starts filling with tears or forming sinuses.
- It becomes older (chronic).
Food items beneficial for this condition
- Vitamin A rich fruits & vegetable
- Smoothie of greens (e.g. Spinach, mint, tulsi leaves grinded in fruit juice as base).
- Introducing browntop millets in diet plan
- Use of Amla (Embellia officianlis) and other citrus fruits.
- Use of legumes.
- Green leafy vegetables.
- Use dry nuts after well soaking and peeling off.
Amyloid Corneal Degeneration usually doesn’t affect the normal visual acuity, but if it does the following are the Ayurvedic principles of treatment as mentioned by Acharyas for Avarna shukra which are to be considered:
The above-mentioned shloka describes the treatment principles for Avarna Shukra as quoted by Acharaya Bhagbhata. (Ref- Ashtaang Hriday Uttarsthana 11/29)
Meaning of Shloka
- Triphala can be administered according to doshas, in diseases of shukra in wet/dried form.
- Use of tikta ghrita.
- Jaloka Avacharan etc. (leech therapy) procedures for Raktamokshan (blood-letting).
- Virechan (detoxification procedure),
- Use of Aaschyotan, putpaka and tarpan etc. (procedures for eyes) procedures.
Planet Ayurveda is a manufacturing unit that makes the Ayurvedic products which are based on herbal preparations as mentioned in our Ayurvedic texts as well as being guided by our experts. The medicines in Planet Ayurveda are basically from natural origin, are duly purified and then the formulations are made with time-tested methods.
Herbal remedies by our experts’ for Amyloid corneal degeneration are
- Bilberry Capsules
- Angel eye Vitale
- Pitta Balance
- Vrihat Vatchintamani Ras
- Brahmi Chyawanprash
- Saptamrit Loh tablets
- Jivantyadi Ghrita
- Curcumin Capsule
1. Bilberry Capsules
It is a mono herb preparation in capsule form, which contains multiple useful chemical constituents that include flavonoids, anthocyanin pigments and other naturally occurring antioxidants that are very much useful in keeping good eye health. Ingredient- standardized extract of Vaccinium myrtillus.
Dosage: 1-2 capsules one or two times a day.
2. Angel Eye Vitale
It is a compound formulation which contains multi vitamins obtained from natural sources having great results for the patients of eye disorders. Few ingredients include vitamin A, vitamin C, vitamin E, zinc, copper etc. All these elements give well nourishment to the eyes.
Dosage: – 1 capsule twice daily after meals.
3. Pitta balance
It is a multi-herbal preparation. Avarna shukra as mentioned above is caused due to rakta dushti i.e. vitiation of blood so with the help of this medicine the balance is obtained by vitiation of pitta which indirectly calms out vitiation of blood and thus proves to be very helpful in. Ingredients include Praval pishti (Coral compound), Akik pishti (Agate compound), Jahar Mohra Pishti, Kaamdudha Rasa, Mukta Pishti (Pearl compound), Giloy Satava (Tinospora cordifolia).
Dosage: 1 capsule once or twice a day.
4. Vrihat Vatchintamani Ras
It is a poly mineral product made from minerals in tablet form as mentioned in classical texts. Ingredients include Swarna Bhasma, Abhraka Bhasma and Rajata Bhasma etc. It helps to keep the nervous system in a healthy state and hence very much beneficial for the eyes.
Dosage: 1-2 tablets two times a day with water.
5. Brahmi Chayawanprash
It is a classical herbal formulation made from many ingredients in avaleha form, which is very much beneficial for the brain and eyes. Ingredients are Brahmi (Bacopa monnieri) with Dashmoola (roots of 10 herbs) etc. Brahmi itself is a brain tonic and contains many antioxidants which helps in clearing out various amyloids or other wastes thus making the eyes’ health good.
Dosage: 2-3 teaspoonful, two to three times daily after meals.
6. Saptamrit loh Tablets
It is a herbo-mineral formulation which contains both mineral and herbs. The mineral ingredient here is Loh bhasma (ash of purified iron) which is very much effective in raktaja disorders (blood disorders) & also good in keeping eyes healthy. Also herbal other ingredients are beneficial for the eyes.
Ingredients include Bibhitaki (Terminalia bellerica), Amlaki (Embilia officinalis) etc.
Dosage: 2 to 3 tablets two times a day with Honey or Ghee.
7. Jivantyadi Ghrita
It is a classical poly herbal preparation with multiple ingredients in ghrit form. According to Ayurveda this ghritam can be used for snehana karma which is beneficial for all the Netra rogas. Also it can be used for various netra tarpan. Here in this disease Jivantyadi ghrita is used for vata kapha Ghana properties and for internal/external oleation therapy to get better results.
- For internal use: 1 teaspoon with warm water or with food (as the patient feels comfortable).
- For external use: Quantity sufficient or as directed by the physician.
8. Curcumin Capsules
It is the herbal formulation obtained from a single ingredient, & is available in capsule formulation. It is an extract of Turmeric (Curcuma longa 95% std. extract). Curcumin has a variety of medicinal properties that include antioxidant, anti-inflammatory, antimicrobial properties. Curcumin belongs to a group of natural antioxidants. Curcumin is rich in strong antioxidant agents. It helps in clearing out various forms of free radicals, so in this disease it is very much beneficial in scavenging the extra amyloids that are responsible for the disease formation.
Dosage: – 1-2 capsules twice or thrice a day.
Contact my assistant to provide you the costing / ordering and delivery information at – firstname.lastname@example.org or call at +91-172-5214030 Or Check Website – www.PlanetAyurveda.com
As described earlier in this article this is a disease that is mostly non progressive and symptomless but it can lead to very serious manifestations including loss of vision. The diagnosis is based on clinical examination Thus, due to the variety of scopes of treatment methods and herbal based medicines including diet modification, one can consider a better way of having treatment of Amyloid Corneal Degeneration with Ayurveda. For more information kindly visit www.planetayurveda.com